Provider Demographics
NPI:1003839077
Name:TANGEMAN, RICK (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RICK
Middle Name:
Last Name:TANGEMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 MEADOWS RD STE 365
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-2233
Mailing Address - Country:US
Mailing Address - Phone:503-624-2737
Mailing Address - Fax:503-624-7976
Practice Address - Street 1:5000 MEADOWS RD STE 365
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-2233
Practice Address - Country:US
Practice Address - Phone:503-624-2737
Practice Address - Fax:503-624-7976
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical